Obesity, which is associated with nonalcoholic fatty liver, has increased among people with type 1 diabetes. A study at Folkhälsan Research Center explored the associations between body fat distribution and nonalcoholic fatty liver in this population.
Non-alcoholic fatty liver disease is the excessive accumulation of fat in the liver, accompanied by insulin resistance unrelated to alcohol consumption, which is an otherwise typical facilitator of fatty liver disease. Nonalcoholic fatty liver disease may progress to fibrosis, cirrhosis and even hepatocellular carcinoma if left untreated.
Non-alcoholic fatty liver disease is typically associated with type 2 diabetes, obesity and insulin resistance. Nevertheless, obesity has increased among individuals with type 1 diabetes during the last years and as a consequence, the incidence of non-alcoholic fatty liver disease in this populations has increased as well.
A study at Folkhälsan Research Center set out to explore the association between body fat distribution and NAFL. This study included 121 adults with type 1 diabetes from the Finnish Diabetic Nephropathy (FinnDiane) Study for whom nonalcoholic fatty liver was determined by magnetic resonance imaging. Body composition was assessed through dual-energy x-ray absorptiometry. The associations between body fat distribution, waist-to-height ratio, body-mass-index, and non-alcoholic fatty liver were explored using logistic regression analysis.
The main finding of the study is that visceral adipose tissue, or abdominal fat located around the organs, is indeed associated with non-alcoholic fatty liver in adults with type 1 diabetes. However, total body fat and the fat of legs and arms were not associated with non-alcoholic fatty liver in adults with type 1 diabetes. Furthermore, the waist-to-height ratio, a marker of visceral adiposity, was better associated with non-alcoholic fatty liver than the body-mass-index. Therefore, our results suggest considering the waist-to-height ratio as a simple and accessible tool when screening for non-alcoholic fatty liver in this population.
Parente E. B., Dahlström E. H., Harjutsalo V., Inkeri J., Mutter S., Forsblom C., Sandholm N., Gordin D. and Groop P-H., on behaf of the FinnDiane Study Group. (2021). The Relationship Between Body Fat Distribution and Nonalcoholoc Fatty Liver in Adults with Type 1 Diabetes. Diabetes Care 2021;44:1-8. https://doi.org/10.2337/dc20-3175
Simon Granroth, Science Communicator